Procedure in Moving the Patient Up in the Bed

EXPECTED BEHAVIOR RATIONALE

1. Adjust the head of the head to a flat
position or make it as low as the
patient can tolerate.
2. Assist the patient to a supine
position.
3. Remove all pillows; then place one
pillow at the head of the bed.
4. Ask the patient to flex both knees
and bring the heels up toward the
buttocks.
5. If the patient can assist, have him
flex or her flex the chin toward the
chest.
If the bed is flat, the nurse avoids working
against gravity.
A pillow at the head of the bed protects the
patient’s head against inadvertent injury.
Flexed knees ensure that the patient uses
the femoral muscles when subsequently
asked to push.
The chin pulled toward the chest prevents
hyperextension of the neck as the head
resists moving against the bed surface.

6. If the patient is able, have him or By grasping the rails, the patient provides
her grasp the rails at the head of the additional power to overcome friction
bed with both hands. when moving up in the bed and also gets
some exercise.

7. If the patient cannot assist, place his
or her arms across the chest.
8. Facing the head of the bed, assume
a broad stance, with the foot nearest
the bed behind the other foot.
9. Flex the head of the bed, assume a
broad stance, with the foot nearest
the bed behind the other foot.
Placing the arms across the chest prevents
them from dragging on the bed surface, and
thus decreases friction.
A broad stance increase balance. This foot
position makes it unnecessary to twist the
body when moving the patient. Flexed
knees and hips allow the nurse to use the
major muscle groups of the thighs and legs
to move the patient, and also bring the
nurse’s base support closer to patient.

10. Place the arm that is nearest the This placement of the arms distributes the
head of the other arm under his or patient’s weight and supports his or her
her thighs. buttocks (the heaviest part of the body).

11. Rock from the back leg to the front
leg and back again, then shift
weight to the front leg as the patient
pushes with his or her heels and
pulls with the arms.
12. Support the patient appropriately.
Rocking helps attain a balanced, smooth
motion and overcome inertia. The nurse’s
weight helps counteract the patient’s
weight.